The Zenith

Senior Workers' Comp Claims Specialist - CA Claims

The Zenith$94K — $127K *
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • California Workers' Compensation Claims Adjuster Certification required.
  • High School Diploma or equivalent required; Bachelor's Degree preferred.
  • 5+ years of experience in Workers' Compensation Claims handling, specifically in California.
  • Advanced knowledge of technical aspects of workers' compensation claims.
  • Strong verbal and written communication skills, particularly over the phone.

Responsibilities

  • Investigate and manage a varied caseload of complex claims under limited direction.
  • Initiate new claims and perform investigations to assess compensability.
  • Set and monitor insurance reserves based on company guidelines.
  • Maintain accurate documentation to support data integrity throughout the claim process.
  • Evaluate and negotiate settlements, liaising effectively with injured workers and their attorneys.
  • Maintain ongoing communication with stakeholders to foster positive relationships and credibility.
  • Implement action plans to achieve claim resolution.

Benefits

  • Medical, Dental, and Vision Insurance.
  • Flexible Spending Accounts.
  • Paid Parental Leave.
  • Life, AD&D, and Disability Insurance.
  • 401(k) and Employee Share Purchase Plan (ESPP).
  • Education and Training Reimbursement.
  • Generous paid leave including vacation, sick leave, and holidays.
  • Employee Assistance Program (EAP).
Full Job Description
Overview

Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of Claims within a certain monetary limit. All tasks are to be performed with the goal of demonstrating Zenith's superior Claims handling expertise.

Responsibilities

  • Under limited direction, works within broad limits and authority on highly complex assignments.
  • Responsible for Claims management of assigned case load within guidelines of published performance standards.
  • Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith's timeframes and guidelines.
  • Sets appropriate reserves according to Zenith's timeframes and guidelines.
  • Follows appropriate procedures for system documentation to preserve data integrity.
  • Monitors and maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith's standards.
  • Creates and executes action plans needed to bring case to closure.
  • Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers' attorneys.
  • Maintains regular contact with injured workers, employers and agents to develop positive relationships and establish credibility.
  • Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
  • Works productively and harmoniously with others on a consistence basis.
  • Respond positively to direction and criticism of performance.
  • Consistently maintain professional and appropriate demeanor.
  • Perform other duties as assigned.


Qualifications

  • Must have California Workers' Compensation Claims Adjuster Certification/ designation.


Education

  • High School Diploma Or equivalent required
  • Bachelor's Degree or equivalent required


Work Experience

  • 5+ years Workers' Compensation Claims handling experience required
  • CA workers Comp claims experience is a must


Knowledge, Skills, and Abilities

  • Advanced technical workers' compensation claims knowledge.
  • Strong verbal and written communication skills with emphasis on telephone communication required.
  • Strong math and reading skills required.
  • Meets all state regulatory standards regarding licensing, continuing education, and other requirements.


Pay, Benefits, and Other Information

The expected salary range for this position is $94,502.68 - $127,972.38 . Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law. Qualifications may warrant placement in a different job level.

Benefits

  • Medical, Dental and Vision Insurance
  • Flexible Spending Accounts
  • Paid Parental Leave
  • Life, AD&D and Disability Insurance
  • 401(k), Employee Share Purchase Plan (ESPP)
  • Education and Training Reimbursement
  • Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave
  • 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays
  • Employee Assistance Program (EAP)
  • For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/


Zenith typically posts jobs for a minimum of 8 to 14 calendar days. If you are interested in any of our open positions, we encourage you to submit your application promptly.

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About The Zenith

The Zenith is a property and casualty insurance company that specializes in workers' compensation insurance. The company was founded in 1949 and is headquartered in Woodland Hills, California. The Zenith offers a range of insurance products and services to businesses of all sizes, including risk management, claims management, and loss control. The company has a strong focus on customer service and has been recognized for its commitment to excellence.
Learn more about The Zenith
Size
1,500 employees
Industry

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